单纯PLIF与PLIF联合PLF治疗腰椎退行性疾病的临床效果对比研究

Comparison of clinical efficacy of PLIF and PLIF joint PLF in the treatment of lumbar degenerative disease

目的对比研究单纯后路椎体间融合术与后路椎体间融合联合后外侧融合术治疗腰椎退行性疾病的疗效。方法选择我院2011年2月～2013年1月收治的腰椎退行性疾病患者100例,其中行单纯后路椎体间融合术47例患者,行后路椎体间融合联合后外侧融合术53例患者。回顾两组患者的病历资料,并比较两组术后的临床效果及影像学表现。并记录术中出血量、术后切口疼痛程度、术后48 h内引流量及并发症发生情况。结果 100例患者均获得随访。两组术中手术时间、出血量、并发症发生率、住院天数等进行比较,差异无统计学意义(P>0.05);术后3 d切口疼痛VAS评分、48 h内伤口引流量,两组比较差异有统计学意义(P<0.05)。两组腰椎前凸角、融合节段前凸角、临床疗效、融合率差异无统计学意义(P>0.05)。结论联用或不联用PLF对椎弓根内固定下PLIF治疗腰椎退行性疾病的短期临床疗效、融合率无明显影响,且椎间融合联合后外侧融合增加住院时间。

Objective To study the efficacy of PLIF and PLIF joint PLF in the treatment of lumbar degenerative disease. Methods A total of 100 cases with lumbar degenerative disease of the author＇s hospital from Feb. 2011 to Jan. 2013 were collected. 47 patients underwent posterior interbody fusion and 53 patients underwent posterior interbody fusion combined with posterolateral fusion. The clinical data of the two groups of patients were retrospectively analyzed. The postoperative clinical effect of two types of bone graft surgery and imaging findings were compared. Blood loss, postoperative incision pain, drainage within 48 h and complications were recorded. Results All of 100 cases were fol- lowed up. The difference of operative time, blood loss, complication rate, the number of days of hospitalization between two groups was not statistically significant （P 〉 0.05）. The difference of 3 d incision pain VAS score ,wound drainage within 48 h and hospital costs were statistically significant （P 〈 0.05）. Lumbar lordosis, fusion segment lordosis, clini- cal efficacy and the fusion rate of the two groups had no significant difference （P 〉 0.05）. Conclusion Short-term clinical efficacy and fusion rate of PLIF pedicle screw fixation associated or not associated with PLF for the treatment of degenerative diseases has no significant effect. Interbody fusion combined with posterolateral fusion increases hospital costs and time.